Reis, D., Walsh, M.E., Young-McCaughan, S., & Jones, T. (2013). Effects of Nia exercise in women receiving radiation therapy for breast cancer [Online exclusive]. Oncology Nursing Forum, 40, E374–E381. 

To compare a 12-week Nia-based exercise program to usual care on cancer-related fatigue, quality of life, aerobic capacity, and shoulder flexibility in women receiving radiation therapy for breast cancer

Participants randomized to the intervention were instructed in Nia techniques as well as given a DVD for home use. They were instructed to perform the exercises for 20–60 minutes at least three times a week and maintain a log. The control group were instructed to maintain their usual exercise regime and maintain a log. The principle investigator met individually with both groups at the beginning and at 6 and 12 weeks. At the end of the 12 weeks, control group participants were given the opportunity to take part in a Nia group.

• N = 41  
• MEAN AGE = 56 (range = 34–85)
• KEY DISEASE CHARACTERISTICS: Patients with breast cancer receiving radiation therapy

• SITE: Single site  
• SETTING TYPE: Outpatient    
• LOCATION: Northern Ohio

• PHASE OF CARE: Active anti-tumor treatment

• Randomized, controlled study stratified by stage or disease and age

• Fatigue and quality of fife were measured by the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F).
• Aerobic capacity measured by a six-minute walk test
• Shoulder flexibility assessed using a goniometer

Both groups reported increased fatigue at week 6 (completing therapy) with improvement at week 12. Repeated measures of covariance noted statistically significant differences in the Nia and control groups between weeks 6 and 12; the Nia group had a greater increase in FACIT-F scores (p = 0.05).

Sample size and study limitations make it difficult to draw conclusions; however, Nia exercise can be beneficial to women with breast cancer receiving radiation therapy to reduce cancer-related fatigue.

• Small sample (< 100)
• Baseline sample/group differences of import
• Risk of bias (no blinding)
• Risk of bias(sample characteristics)
• Selective outcomes reporting
• Findings were not generalizable
• Intervention expensive, impractical, or training needs
• Questionable protocol fidelity
• Subject withdrawals ≥ 10% 
• Other limitations/explanation: Control group had less fatigue at baseline; both groups reported that keeping a diary reminded them to exercise

Nia exercise can be beneficial to women with breast cancer receiving radiation therapy, particularly those who favor a holistic or complementary approach.